Implementing patient safety and quality improvement in dermatology. Part 1: Patient safety science - 16/09/23

Doi : 10.1016/j.jaad.2022.01.049

Amanda Marsch, MD ^a, Rita Khodosh, MD ^b, Martina Porter, MD ^c, Jason Raad, PhD ^d, Sara Samimi, MD ^e, Brittney Schultz, MD ^f, Lindsay Chaney Strowd, MD ^g, Laura Vera, MSW, LSW ^d, Emily Wong, MD ^h, Gideon P. Smith, MD, PhD, MPH ^i,^⁎
^a University of California, San Diego Medical Center, San Diego, California
^b Department of Dermatology, University of Massachusetts, Boston, Massachusetts
^c Department of Dermatology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
^d American Academy of Dermatology, Rosemont, Illinois
^e University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
^f Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
^g Wake Forest University School of Medicine, Winston-Salem, North Carolina
^h San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
ⁱ Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts

^∗Reprint requests: Gideon P. Smith, MD, PhD, MPH, Department of Dermatology, Massachusetts General Hospital/Harvard Medical School, 50 Staniford Street, Suite 200, Boston, MA 02114.Department of DermatologyMassachusetts General Hospital/Harvard Medical School50 Staniford StreetSuite 200BostonMA02114

Abstract

Patient safety (PS) and quality improvement (QI) have gained momentum over the last decade and are becoming more integrated into medical training, physician reimbursement, maintenance of certification, and practice improvement initiatives. While PS and QI are often lumped together, they differ in that PS is focused on preventing adverse events while QI is focused on continuous improvements to improve outcomes. The pillars of health care as defined by the 1999 Institute of Medicine report “To Err is Human: Building a Safer Health System” are safety, timeliness, effectiveness, efficiency, equity, and patient-centered care. Implementing a safety culture is dependent on all levels of the health care system. Part 1 of this CME will provide dermatologists with an overview of how PS fits into our current health care system and will include a focus on basic QI/PS terminology, principles, and processes. This article also outlines systems for the reporting of medical errors and sentinel events and the steps involved in a root cause analysis.

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Key words : failure mode and effects analysis, improvement activities, merit-based incentive program, near misses, outcome and process assessment, patient safety, practice management, program evaluation, quality assurance, quality improvement, quality indicators, quality measures, root cause analysis, safety culture

Abbreviations used : IOM, PS, QI, RCA